| NPI | 1588636005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 163396-0) |
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: PA MD042029E) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CT 049363) | |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: NY 163396-0) | |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2014-12-09 |